African American men with small prostates, for example, might consider using PCPT-RC results to "boost" ERSPC-RC or 4Kscore results.

Differences between PCPT and ERSPC Risk Calculators

The risk calculators use different variables:

PCPT-RC for race, Free PSA %, age and family history with African American race a big factor

ERSPC-RC for prostate volume, PHI and TRUS

PSA, DRE and previous biopsy are used by both PCPT-RC and ERSPC-RC with different effects:

DRE: Abnormal vs normal DRE has a much bigger effect on ERSPC-RC than PCPT-RC. Use the ERSPC-RC with caution with abnormal DRE. The difference may be between US (PCPT-RC) practice and European (ERSPC-RC) practice

Previous Biopsy: Negative vs no previous biopsy has a stronger effect on ERSPC-RC than PCPT-RC

4Kscore Cancer Risk Factor Estimates

4Kscore acts like a risk calculator that considers a panel of four PSA related blood tests, age, DRE and previous biopsy.

Cancer risk factors based on 4Kscore values are shown below for the 15-year age 71 at 3 PSA case:

2.5% 4Kscore:

0.5X

5% 4Kscore:

0.8X

10% 4Kscore:

1.5X

20% 4Kscore:

2.9X

30% 4Kscore:

4.3X

40% 4Kscore:

5.6X

NOTE: If your 4Kscore is elevated, consider a follow-up 4Kscore for the same reasons to follow-up an elevated PSA.PSA and 4Kscore can be increased by a temporary condition (infection or inflammation) that may moderate at follow-up.

PCPT Risk Calculator Cancer Risk Factor Estimates

Cancer risk factors based on PCPT-RC variables are shown below for the 15-year age 71 at 3 PSA case for Caucasian and other race men and for African American men:

NOTE: If your Free PSA % is low, consider a follow-up Free PSA for the same reasons to follow-up an elevated PSA.Free PSA % can be decreased by a temporary condition (infection) that may moderate at follow-up.

Caucasian, Hispanic and Other Race Men

Free PSA%

20% - 0.9X15% - 1.5X10% - 3.1X

DRE

None - 1.0XNorm - 1.0XAbnorm - 1.4X

Fam History

No - 1.0XYes - 1.2X

PSA

2 - 0.7X3 - 1.0X4 - 1.3X

Age

71 - 1.0X73 - 1.0X​75 - 1.0X

Prior Biopsy

None - 1.0X​Neg - 0.8XNotSure - 1.0X

Abnormal DRE &​Free PSA%

15% - 1.5X10% - 3.1X

African American Men

Free PSA%

20% - 2.0X15% - 3.0X10% - 5.4X

DRE

None - 2.2XNorm - 2.2XAbnorm - 2.9X

Fam History

No - 2.2XYes - 2.5X

PSA

2 - 1.6X3 - 2.2X4 - 2.6X

Age

71 - 2.2X73 - 2.3X​75 - 2.4X

Prior Biopsy

None - 2.2X​Neg - 1.8XNotSure - 2.0X

Abnormal DRE &Free PSA%

15% - 3.0X10% - 5.4X

ERSPC Risk Calculator Cancer Risk Factor Estimates

Cancer risk factors based on ERSPC-RC variables are shown below for the 15-year age 71 at 3 PSA case for various cases:

PSA, No DRE, No Prostate Volume, No PHI, No TRUS Ultrasound

No Previous Biopsy

2 PSA - 0.5X3 PSA - 0.9X4 PSA - 1.2X

Negative Previous Biopsy

2 PSA - 0.2X3 PSA - 0.3X4 PSA - 0.3X

DRE with Prostate Volume, PSA 3, No Previous Biopsy, No PHI, No TRUS

25cc Prostate Volume

Normal DRE - 1.0XAbnorm DRE - 3.7X

40cc Prostate Volume

Normal DRE - 0.4XAbnorm DRE - 1.7X

60cc Prostate Volume

Normal DRE - 0.2XAbnorm DRE - 0.7X

No Prostate Volume

Normal DRE - 0.4XAbnorm DRE - 2.0X

Vertical Divider

​CAUTION: Abnormal DRE causes a very much larger increase in cancer risk for ERSPC-RC than for PCPT-RC.If abnormal DRE, consider TRUS ultrasound or MRI because a tumor large enough to be felt may be seen on images.

25cc Prostate Volume

40cc Prostate Volume

5 PHI - 0.5X10 PHI - 0.9X20 PHI - 1.6X40 PHI - 2.6X80 PHI - 3.9X

60cc Prostate Volume

5 PHI - 0.3X10 PHI - 0.6X20 PHI - 1.0X40 PHI - 1.7X80 PHI - 2.7X

NOTE: If your PHI is elevated, consider a follow-up PHI for the same reasons to follow-up an elevated PSA.PSA and PHI can be increased by a temporary condition (infection or inflammation) that may moderate at follow-up.